Patient Registration Workflow

At a glance

Every patient walks: Registration → Triage → Vital signs → Unit allocation → Hand-off. ESI 1–2 cases skip the queue and notify the MO immediately. All other patients flow through in queue order with abnormal vitals auto-flagged in CCMS.

Scope

This workflow covers every walk-in patient from arrival at the registration counter until they are seated in a specific unit room for clinical assessment. It applies to all KKM CCMS facilities. Booked follow-up appointments and pre-scheduled procedures follow a separate workflow.

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The 5 stages

1

Registration / verify identity

MR Staff

• Confirm full name, IC number, and MRN (if returning patient)
• Search CCMS by IC; if no record exists, create a new patient record
• Capture / verify contact number and current address
• Print and hand the patient a queue token (paper or QR-coded)

2

Triage — acuity classification

JM/MA

Use the Emergency Severity Index (ESI) 1–5 categories:

• ESI 1–2 — Immediate / Emergent: skip the queue → notify MO immediately. Examples: airway compromise, severe haemorrhage, suspected stroke/MI, altered mental status.
• ESI 3 — Urgent: priority slot within 30 min. Examples: moderate dyspnoea, persistent vomiting, severe pain.
• ESI 4–5 — Less urgent / Non-urgent: standard queue. Examples: stable chronic-disease follow-up, minor injury, prescription refill.

Document the ESI level in CCMS. The triage screen flags it visually to the clinical team.

3

Vital signs capture

JM/MA

Record directly in CCMS Vital Signs module — abnormal ranges auto-flag in red.

Required vitals (all patients)

• Temperature (°C)
• Blood pressure (mmHg) — both arms on first visit or any cardiac complaint
• Pulse rate + rhythm (regular / irregular)
• Respiratory rate (per minute)
• SpO₂ (% on room air)
• Pain score (0–10 numeric scale)

Add for new visits + NCD follow-ups

• Weight (kg) — BMI auto-calculates if height present
• Height (cm) — required on first visit, then annually
• Random capillary glucose (mmol/L) — NCD follow-up only

4

Symptom-driven unit allocation

JM

Based on the patient's chief complaint and any clinical alerts, allocate to the appropriate unit — see the decision matrix below.

5

Hand-off to the assigned unit

• Update the CCMS patient-location field → "In Unit X"
• Hand the physical token (or print a unit chit) to the unit nurse
• Verbally communicate any triage flags or abnormal vitals
• Time-stamp the hand-off in CCMS for audit + flow-time tracking

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Unit allocation — decision matrix

ALLOCATION BRANCHES

OPD

General consultation — acute illness, minor injury, non-NCD review

NCD

Diabetes, hypertension, dyslipidaemia follow-up

KKIA

Antenatal, postnatal, child wellness, family planning

Procedure

Wound dressing, suturing, minor procedures, injections

Other units (radiology, lab, pharmacy) are downstream — allocated by the consulting MO, not at registration.

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Critical safety notes

ESI 1–2 always bypasses the queue

Any patient with airway compromise, severe haemorrhage, suspected stroke or MI, or altered mental status is immediate priority. Notify the on-call MO before completing routine vitals. Do not wait for queue position. Document the bypass with timestamps for clinical audit.

Repeat abnormal vitals before escalating

Single-reading hypertension or tachycardia is common immediately after queueing in a busy waiting area. Repeat blood pressure and pulse after 5 minutes of seated rest before flagging the MO. Document both readings in CCMS so the consulting clinician sees the trend.

CCMS downtime — fall back to BCP

If CCMS is unavailable during registration, switch to the paper-based registration form and queue-card system per the clinic's Business Continuity Plan. Backfill into CCMS as soon as the system is back online — backdate the registration timestamp to the actual arrival time.